Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or South Dakota for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to South Dakota only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. South Dakota (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Monument Health Network, Inc. (NPI 1427243963)

Field	Value
Entity Type	Organization
Organization	Monument Health Network, Inc.
Address	1220 Montgomery St
City	Custer
State	SD
ZIP	57730
Taxonomy	Family Medicine Physician
NPI Enumerated	September 7, 2007

Payer Source	Total Paid
Medicaid	$639K
Medicare	$0

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

84 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	5,100	$40	$183.7K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	2,650	$50	$137.9K
90999	Use 90999 to report dialysis services or procedures that do not have a specific code.	3,110	$10	$40.4K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	740	$40	$31.6K
W0037	N/A	1,890	$20	$28.3K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	760	$30	$23.4K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	1,650	$10	$16.5K
93005	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	1,360	$10	$16.3K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	350	$50	$15.8K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	810	$20	$12.1K

Showing 1–10 of 84

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other South Dakota providers billing the same CPT/HCPCS codes.

Claims Volume vs. South Dakota Distribution

Monument Health Network, Inc. — 0 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Dakota

Full comparison — all codes billed, vs. South Dakota median

84 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
90999	Use 90999 to report dialysis services or procedures that do not have a specific code.	14	30	3,520	$50	$769.4K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	72	340	1,010	$100	$511K
A0427	Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)	28	40	270	$180	$281.6K
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	30	40	340	$90	$234.9K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	58	260	860	$80	$222.6K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	38	60	680	$60	$205.7K
A0429	Ambulance service, basic life support, emergency transport (bls-emergency)	25	30	300	$150	$195.3K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	43	70	200	$80	$176.7K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	28	70	400	$40	$172.5K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	29	60	120	$210	$171.2K

Showing 1–10 of 84

Related Providers

Other providers that share a Tax Identification Number (TIN) with Monument Health Network, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Monument Health Rapid City Hospital, Inc	SD	Multi-Specialty Clinic/Center	$0	$18.7M
Monument Health Rapid City Hospital, Inc.	SD	General Acute Care Hospital	$0	$11.5M
Monument Health Rapid City Hospital, Inc.	SD	Multi-Specialty Clinic/Center	$0	$5.2M
Richard White	AR	Hematology & Oncology Physician	$2.2M	$0
Monument Health Network, Inc.	SD	Multi-Specialty Clinic/Center	$0	$2M
Jennifer May	SD	Internal Medicine Physician	$1.9M	$0
Monument Health Network, Inc.	SD	Multi-Specialty Clinic/Center	$0	$1.8M
Monument Health Rapid City Hospital, Inc.	SD	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.6M
Luke Hushagen	SD	Internal Medicine Physician	$1.4M	$0
Don Wynn	TX	Pulmonary Disease Physician	$1.4M	$0

Nearby Providers

Other providers in the same ZIP code as Monument Health Network, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Custer Ambulance Service Inc	SD	Ambulance	$194K	$2.5K
Brandyn Tarap	SD	Family Medicine Physician	$185.4K	$0
Monument Health Network, Inc	SD	Assisted Living Facility	$0	$91.2K
Premier Family Eye Care, PC	SD	Optometrist	$0	$73.2K
Nathan Wiederholt	SD	Optometrist	$57.5K	$0
Custer School District	SD	Local Education Agency (LEA)	$0	$45.3K
Monument Health Network, Inc	SD	Critical Access Hospital	$0	$44.1K
Christopher Wenger	SD	Family Medicine Physician	$42.1K	$0

Monument Health Network, Inc. — Billing Profile & Reimbursement Data

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Monument Health Network, Inc. — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References